Compliance or Critical Thinking?

By Terry A. Kupers, M.D., M.S.P.

(Many thanks to Willow Katz and Dolores Canales for support and editing)

Prisoners consigned to solitary confinement or Security Housing Unit (SHU) are derided as “the worst of the worst.”  But when I enter SHUs around the country in preparation for expert testimony in class action litigation, I find very ordinary people, with some exceptions.  There are very bright people, and there are not so bright people, just as in the community.  There are mean and ornery people and there are peaceful and very caring people, just as in the community (and in prison the peaceful and caring are much more numerous).  

The exceptions include the fact that: 1. A disproportionate number of prisoners in solitary suffer from serious mental illness (S.M.I.) — either they were diagnosed before entering solitary or they developed emotional problems on account of the harsh conditions — and that’s why, when I started touring supermax solitary confinement units in the 80s and 90s, I found that 50% of SHU-dwellers suffered from S.M.I.; 2.  A disproportionate number are people of color — the racism that permeates the criminal “justice” system does not stop at the prison walls; and 3.  A large proportion of individuals in solitary confinement are very bright and very political — I think officers are intimidated by willful and very intelligent prisoners, and selectively send them to solitary.  Of course, the subgroups can overlap, so there are no sharp boundaries.  In any case, the population in SHUs are very far from “the worst of the worst.”

When I set out to interview and examine the plaintiffs in the Ashker v. Governor of California lawsuit about unconstitutional conditions and a lack of due process at the Pelican Bay State Prison SHU, I met men in the second and third categories, people of color and very bright and very political.  There were not very many prisoners who suffer from S.M.I. because prior litigation, Coleman v. Governor of California, resulted in a federal court order that SHU residents receive mental health evaluations and those suffering from S.M.I. be transferred to special units, the Psychiatric Services Units (PSUs), where they might receive mental health treatment.  Of course, conditions in the PSUs closely approximate SHU conditions except that prisoners are moved from their cells to “cages” (the staff call them “treatment or programming modules”) for mental health sessions.  

A majority of the inhabitants of the Pelican Bay SHU were alleged to be “gang-affiliates” or members, based on “confidential information,” typically meaning other prisoners had informed they were gang-related.  Those other prisoners were granted privileges or released from SHU in exchange for their “snitching,” and of course the prisoners in SHU had never been told what evidence there was against them, nor were they given an opportunity to defend themselves against the charge of gang-affiliation.  So, in an average case, a Latinx man from an East L.A. barrio was seen giving the high five to a suspected gang member, or wrote a letter to a cousin in prison who was suspected of gang-affiliation, and from then on he was classified gang-affiliated and sent to SHU.  

Alleged gang-affiliation was sufficient cause for the CDCR to consign prisoners to SHU for the remainder of their lives, unless they were willing to snitch on other prisoners (the “debriefing” process), reach the end of their prison sentence (parole), or die.  Prisoners described their choices as “snitch, parole or die.”  The Ashker settlement supposedly ended the practice of sending prisoners to SHU for alleged gang-affiliation alone.  

The 24 prisoners I interviewed were all very bright, many were very well read, and all of them were very aware of and articulate about social injustices and inequities.  On average, they had gotten into trouble with the law as teenagers, maybe were doing drugs, and in some cases they were involved with street gangs.  Almost all of them dropped out of school before graduating high school.  They entered the criminal legal system in their late teens or early twenties, settled down and looked back with regret on their criminal ways (or, a significant number were actually innocent of the charges against them, having been falsely convicted on the basis of tampered or bribed witness identification, the same unfortunate process that would get them consigned to SHU and then denied parole). 

I found myself face-to-face with men I found simpatico, and very interesting to talk to.  I rarely find people in the wider community who have so thoroughly studied philosophy and history and are conversant with the theories not only of Freud, Marx, and Darwin, but also Malcolm X, Franz Fanon and Che Guevera.  But in the Pelican Bay SHU these were studies and theories that might pop into the conversation at any moment.  The men had started studying on their own as soon as they entered prison, earned their G.E.D.s, took college courses when permitted, and in many cases studied the law and became jailhouse lawyers, helping other prisoners with their appeals and legal cases.  In fact, the Ashker v. Governor of California lawsuit began as a pro se case (meaning prisoners act as their own attorneys) brought by plaintiffs Todd Ashker and Danny Troxell.  Imagine how difficult it is to study law and file claims from a windowless cell with no library privileges except being able to request a few specific books or cases and hope officers will deliver them to the cell.

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IF YOU ARE A HELPING PROFESSIONAL (MD, DO, NP, PA, PHD PsyD, LCSW, MSW, MFT) PLEASE CONSIDER SIGNING THIS

END PROLONGED SOLITARY CONFINEMENT
https://www.change.org/p/helping-professional-organizations-end-prolonged-solitary-confinement

The following is from Mariposa McCall, MD Psychiatrist:

Dear Colleagues,

On February 8, 2018, I along with three other presenters (Dr Everett Allen, an internist who worked for several years at California Pelican Bay State Prison’s solitary confinement, a UCSF Public Health and Criminal Justice researcher Cyrus Ahalt, and Steven Czifra who was confined in solitary confinement for 8 years and is now is a U.C. Berkeley MSW intern) presented on the relevance of solitary confinement to community psychiatry to my colleagues at the California Contra Costa County Psychiatry and Psychology monthly meeting.  Solitary confinement is being held in a small cell for 22 to 24 hours a day with minimal property and minimal meaningful human contact. We reviewed the overwhelming evidence of the physical and psychological harms of solitary confinement. In addition, we discussed the ethical dilemmas for providers as they participate in this practice.

Another psychiatrist present suggested I write a petition…..
https://www.change.org/p/american-medical-association-end-prolonged-solitary-confinement

Canada declared solitary confinement unconstitutional in Jan 2018. A few months later India too acknowledged this preventable harm. When will this nation reach this decision? On any given day in USA, 100,000 are held in these extreme conditions, some unconscionably for years and decades.  50% of suicides occur in these restrictive segregation, and self injurious behaviors are rampant.  This is preventable.  We as providers will see these individuals as patients when released,  95% will be released.  As community members, we will walk, shop, eat, live with them. Do we want traumatized human beings or rehabilitated individuals? As providers, is it ethical to declare someone fit for this high risk containment? This is what is happening…we are witnesses and participants.

Some of you may feel this issue does not pertain to your field. Ethical guidelines of “first do no harm” and human rights concern us all.

I am hoping you will join me in signing this petition I wrote to end prolonged solitary confinement (greater than 15 days) in U.S.  jails, prisons, and detention centers.

If you are a medical provider of any specialty, a psychologist, a SW, a NP or a PA please consider signing and forwarding to other of our colleagues.

Sincerely,
Mariposa McCall, MD
Psychiatrist

The petition is directed to the American Medical Association, American Psychiatric Association, American Psychology Association, American Academy of Psychiatry and the Law, American Association of Nurse Practitioners, American Association of Physician Assistants, and National Association of Social Workers. Here is an excerpt:

…. Lastly, we pledge that solitary confinement is in direct violation of our code of ethics as healers, knowing the risks of such placement. Rule 43 of the Mandela Rules of the United Nations Standard Minimum Rules on the Treatment of Prisoners prohibits both indefinite solitary confinement and prolonged solitary confinement (defined as lasting more than 15 days).

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LETTER WRITING LAUNCH to end harmful “security / welfare checks”

STOP SLEEP DEPRIVATION in CA Solitary Units in Pelican Bay SHU and Women’s Death Row

Please write letters to Lindsay Hayes, the suicide expert who’s endorsed this harmful practice by CA Dept. of Corrections.  Hayes can stop the “security/welfare checks.” We want Hayes to hear the voices of the women and men affected by these torturous checks, and we ask you to be the messengers.

Use these templates and prisoner quotes, and send to the listed addresses:

 Write to:
Lindsay M. Hayes

40 Lantern Lane
Mansfield, MA 02048

Copy to:
Matthew A. Lopes, Jr.
Pannone Lopes Devereaux & West LLC
317 Iron Horse Way, Suite 301
Providence, RI 02908

If possible, send us a copy of your letter, either by U.S. mail or email:
PHSS Committee to End Sleep Deprivation
P.O. Box 5692
Eureka, CA 95502
phssreachingout@gmail.com

The negative health consequences of inadequate sleep ha[ve] been extensively documented and nowhere in the literature is there a report on as severe a disruption in sleep as is occurring in the Pelican Bay SHU.”
– Dr. Jamie Zeitzer, internationally recognized sleep expert, Oct. 2015

Guards are jarring prisoners awake every 30 minutes, all day and night, in Central California Women’s Facility death row and in Pelican Bay SHU with noisy so-called  “security/ welfare checks,” causing severe sleep deprivation. These checks are purported to be ‘suicide prevention,’ yet are being used as a blanket practice, whether prisoners are suicidal or not, and despite the fact that denial of sleep is devastating for the human mind and body.

This is torture. We are being emotionally, mentally and physically battered by the security checks throughout the nights.” 20 death row prisoners in Central California Women’s Facility (CCWF)

People need sleep for survival, mental and physical health and well-being, and to organize for their human rights.

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Sleep Expert Reports about 30 minute “welfare checks”

 

excerpted from Dr. Jamie Zeitzer’s Oct 2015 Report:
” …While this was instituted as a safety measure, including the prevention of suicides, it has created an even more disrupted sleep environment, one that will actually lead to an increase in suicidal ideation…

An extensive literature that covers the gamut from animal studies to highly controlled studies in humans to epidemiologic studies of many different populations from around the world all come to the same conclusion – there are serious ramifications of sleep loss on both physical and mental health. … A recent series of studies in Veterans has further pointed to the strong connection between suicidality and sleep, so much so that treatment of sleep problems in Veterans is considered part of the first line of treatment in reducing the risk of suicides. The negative health consequences of inadequate sleep has been extensively documented and nowhere in the literature is there a report on as severe a disruption in sleep as is occurring in the Pelican Bay SHU. …

There have been no direct studies of intentionally waking an individual every thirty minutes every night for days, weeks, or months, as doing so would he considered highly unethical in a research environment. …”

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